Referral Center

Built for busy referral coordinators.

Download a referral form, then fax or email it to us. Every referral reaches a real person who takes ownership immediately — no portals to log into, no waiting.

Step 1 — Download a form

Fillable PDFs you can complete on screen or print.

Patient Referral Form

Primary intake form for new patient referrals.

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Prescription / Order Form

For prescribers submitting infusion orders.

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Note: PDF files should be placed in the site’s /public/forms/ folder using the filenames configured in the content file. Until then these links are placeholders.

Step 2 — Send it to us

Fax is preferred for completed forms containing patient information.

Preferred

Fax

855-872-5872

The fastest, most secure way to send completed referrals.

Phone

855-855-3221

Call to refer by phone or ask a question — a real person answers.

orders@biologicinfusion.com

Send to our monitored intake inbox.

A note on patient privacy: When sending completed forms that contain patient health information by email, please use your organization’s secure or encrypted email. Fax remains the preferred method for protected health information.